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        "resumen" => "Background and objective: Knowledge of the life-sustaining treatment preferences of the dialysis patients would be extremely helpful to substitute decision-makers and nephrologists in deciding whether to continue or stop a treatment. The population of the Mediterranean countries show this opinion with less frequency. The objective of this study is: 1) the knowledge of the patient's view for the advance directives&#59; it may increase the likelihood to get the correct decisions of the staff when complications break the normal course of chronic dialysis, and 2) the statement of the advance directives.Material and method: We distributed 135 questionnaires to patients with chronic renal failure in dialysis treatment of the Sabadell´s Hospital to explore demographic information about responders and not-responders and explore the rate of questionnaires was completed about the cardiopulmonary resuscitation, respirator, tube feeding and dialysis in case of coma, persistent vegetative state, severe dementia and terminal illness. We explore about the representative of patients and in case of not-responders about the cause to not answer. Results: Sixty-four of 135 patients (47,8%) did not want cardiopulmonary resuscitation, respirator, tube feeding or dialysis in case of coma, persistent vegetative state, severe dementia or terminal illness. Compared with patients who wanted the treatments, those who did not were older (71,2 versus 62,2 years&#59; p = 0.002). There was no difference in the other demographic questions, including sex (p=0.674), cause of kidney failure (p=0.815), comorbid conditions (p=0.824), and social status (language of questionnaire -0.155- and standard of education -0.288-). Advance care planning does not occur solely within the context of the physician-patient relationship&#59; the respondents reported the representative in the family, essentially. The patients not-responders doesn´t want to think in those situations and also they show doubt about the interpretation of their answers. Conclusions: near 50% patients in chronic dialysis want to stop certain treatments in case of resuscitation cardiopulmonary, coma, persistent vegetative state, severe dementia or terminal illness. The older patients want the limitation of treatments more frequently."
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        "resumen" => "Fundamento y objetivo: En la cultura latina no hay experiencia sobre estudios que definan la opinión de los pacientes con enfermedades crónicas acerca de cómo quisieran ser tratados en caso de complicaciones severas que inhabiliten su calidad de vida y su capacidad para decidir. El objetivo del estudio es: 1) tener el conocimiento de esas opiniones que podrían facilitar las decisiones de los médicos que tratan a estos enfermos, en el caso especial de surgir complicaciones que alteren esa capacidad de decidir de los pacientes, y 2) la invitación a la verdadera elaboración de un documento de voluntades anticipadas. Material y método: Se facilita un cuestionario a 135 pacientes de la Unidad de Hemodiálisis del hospital de Sabadell, en el que se les pregunta si desearían limitaciones terapéuticas (resucitación cardiopulmonar en caso de paro cardiorrespiratorio, ventilación mecánica, alimentación artificial, seguir en proceso de diálisis) en caso de estar en coma profundo, estado vegetativo, demencia profunda irreversible o enfermedad crónica en fase terminal. Se establecen diferencias epidemiológicas entre los pacientes que manifiestan desear esas limitaciones en esas circunstancias y los que no lo hacen. Se pregunta sobre el representante en caso de incapacidad y acerca de los motivos por los que no contestan a los pacientes que no responden el cuestionario. Resultados: Entre los dos grupos de pacientes, tan sólo la edad les diferencia significativamente (p = 0,002) pues el promedio de edad de los enfermos que quisieran limitaciones es de 71,2 años y el del que no manifiestan querer limitaciones es de 62,2 años. El sexo (p = 0,674), comorbilidad (p = 0,824), estudios (p = 0,288), factores culturales como el idioma (p = 0,155) y nefropatía primaria (p = 0,815) no ofrecen diferencias entre ambos grupos. Un 47,8% de los pacientes de nuestro medio tratados con diálisis crónica, se manifiestan abiertamente partidarios de limitar esfuerzos terapéuticos en alguna de las circunstancias mencionadas. La mayoría de pacientes que realizan voluntades anticipadas tienen como representante un familiar, especialmente hijos. Los que no responden al cuestionario no lo hacen principalmente por rechazar la posibilidad de pensar en ello y también por desconfianza. Conclusiones: En nuestro medio, casi el 50% de los pacientes tratados mediante hemodiálisis periódica son partidarios de limitar ciertos tratamientos en circunstancias de pronóstico infausto, siendo los enfermos más ancianos los más partidarios a manifestar la voluntad sobre esas limitaciones."
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Advance directives in chronic dialysis patients
DOCUMENTO DE VOLUNTADES ANTICIPADAS DE PACIENTES CN INSUFICIENCIA RENAL CRÓNICA TERMINAL EN TRATAMIENTO SUSTITUTIVO MEDIANTE DIÁLISIS
Ángel Rodríguez Jornet, José Ibeas, Jordi Real, Silvia Peña, Juan Carlos Martínez Ocaña, Manuel García García
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        "resumen" => "Background and objective: Knowledge of the life-sustaining treatment preferences of the dialysis patients would be extremely helpful to substitute decision-makers and nephrologists in deciding whether to continue or stop a treatment. The population of the Mediterranean countries show this opinion with less frequency. The objective of this study is: 1) the knowledge of the patient's view for the advance directives&#59; it may increase the likelihood to get the correct decisions of the staff when complications break the normal course of chronic dialysis, and 2) the statement of the advance directives.Material and method: We distributed 135 questionnaires to patients with chronic renal failure in dialysis treatment of the Sabadell´s Hospital to explore demographic information about responders and not-responders and explore the rate of questionnaires was completed about the cardiopulmonary resuscitation, respirator, tube feeding and dialysis in case of coma, persistent vegetative state, severe dementia and terminal illness. We explore about the representative of patients and in case of not-responders about the cause to not answer. Results: Sixty-four of 135 patients (47,8%) did not want cardiopulmonary resuscitation, respirator, tube feeding or dialysis in case of coma, persistent vegetative state, severe dementia or terminal illness. Compared with patients who wanted the treatments, those who did not were older (71,2 versus 62,2 years&#59; p = 0.002). There was no difference in the other demographic questions, including sex (p=0.674), cause of kidney failure (p=0.815), comorbid conditions (p=0.824), and social status (language of questionnaire -0.155- and standard of education -0.288-). Advance care planning does not occur solely within the context of the physician-patient relationship&#59; the respondents reported the representative in the family, essentially. The patients not-responders doesn´t want to think in those situations and also they show doubt about the interpretation of their answers. Conclusions: near 50% patients in chronic dialysis want to stop certain treatments in case of resuscitation cardiopulmonary, coma, persistent vegetative state, severe dementia or terminal illness. The older patients want the limitation of treatments more frequently."
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        "resumen" => "Fundamento y objetivo: En la cultura latina no hay experiencia sobre estudios que definan la opinión de los pacientes con enfermedades crónicas acerca de cómo quisieran ser tratados en caso de complicaciones severas que inhabiliten su calidad de vida y su capacidad para decidir. El objetivo del estudio es: 1) tener el conocimiento de esas opiniones que podrían facilitar las decisiones de los médicos que tratan a estos enfermos, en el caso especial de surgir complicaciones que alteren esa capacidad de decidir de los pacientes, y 2) la invitación a la verdadera elaboración de un documento de voluntades anticipadas. Material y método: Se facilita un cuestionario a 135 pacientes de la Unidad de Hemodiálisis del hospital de Sabadell, en el que se les pregunta si desearían limitaciones terapéuticas (resucitación cardiopulmonar en caso de paro cardiorrespiratorio, ventilación mecánica, alimentación artificial, seguir en proceso de diálisis) en caso de estar en coma profundo, estado vegetativo, demencia profunda irreversible o enfermedad crónica en fase terminal. Se establecen diferencias epidemiológicas entre los pacientes que manifiestan desear esas limitaciones en esas circunstancias y los que no lo hacen. Se pregunta sobre el representante en caso de incapacidad y acerca de los motivos por los que no contestan a los pacientes que no responden el cuestionario. Resultados: Entre los dos grupos de pacientes, tan sólo la edad les diferencia significativamente (p = 0,002) pues el promedio de edad de los enfermos que quisieran limitaciones es de 71,2 años y el del que no manifiestan querer limitaciones es de 62,2 años. El sexo (p = 0,674), comorbilidad (p = 0,824), estudios (p = 0,288), factores culturales como el idioma (p = 0,155) y nefropatía primaria (p = 0,815) no ofrecen diferencias entre ambos grupos. Un 47,8% de los pacientes de nuestro medio tratados con diálisis crónica, se manifiestan abiertamente partidarios de limitar esfuerzos terapéuticos en alguna de las circunstancias mencionadas. La mayoría de pacientes que realizan voluntades anticipadas tienen como representante un familiar, especialmente hijos. Los que no responden al cuestionario no lo hacen principalmente por rechazar la posibilidad de pensar en ello y también por desconfianza. Conclusiones: En nuestro medio, casi el 50% de los pacientes tratados mediante hemodiálisis periódica son partidarios de limitar ciertos tratamientos en circunstancias de pronóstico infausto, siendo los enfermos más ancianos los más partidarios a manifestar la voluntad sobre esas limitaciones."
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Article information
ISSN: 20132514
Original language: English
DOI:
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Nefrología (English Edition)